To investigate the short-term efficacy of anisodamine hydrobromide (654-1) combined with blood purification therapy in patients with septic shock.

The clinical data of 76 patients with septic shock admitted to Linfen People’s Hospital between December 2023 and March 2025 were analyzed, retrospectively. According to different treatment strategies, patients were divided into blood purification group (41 cases), who received conventional anti-infection therapy, fluid resuscitation and blood purification; and patients in 654-1+blood purification group (35 cases) received additional 654-1 on the basis of conventional treatment and blood purification. The baseline characteristics, inflammatory markers, markers related to multiple organ function and prognostic outcomes between the two groups were compared, respectively. Baseline data was analyzed by Chi-square test and Mann-Whitney U test. Longitudinal data were analyzed by repeated-measures analysis of variance and generalized estimating equations.

The baseline characteristics between patients of blood purification group and 654-1+blood purification group at admission were without significant differences (all P>0.05). At 24 h, 48 h and 72 h after blood purification therapy, inflammatory markers, including C-reactive protein, procalcitonin, interleukin-6 and interleukin-10 were significantly lower in patients of 654-1+blood purification group than those of blood purification group (all P<0.001). Compared with patients in blood purification group, at 2 h after blood purification therapy, markers related to multiple organ function in 654-1+blood purification group showed significantly lower levels of serum creatinine (Z=2.871, P=0.004), blood urea nitrogen (Z=3.074, P<0.001) and blood lactate (Z=2.666, P=0.008), as well as higher urine output (Z=3.111, P=0.002) and lower alanine aminotransferase (Z=3.007, P=0.003) and aspartate aminotransferase levels (Z=3.590, P<0.001). However, no significant difference in SOFA scores was observed between the two groups (Z=1.165, P=0.244). The counts of red blood cell (RBC) and platelets in both groups showed a declining trend within the first 48 h after treatment. From 72 h onward, RBC counts of patients in 654-1+blood purification group gradually increased and were significantly higher than those of blood purification group at 72 h, 96 h, 120 h, 144 h and 168 h after blood purification therapy (all P<0.001). Meanwhile, platelet counts in 654-1+blood purification group exhibited a sustained upward trend and were significantly higher than those of blood purification group at the same time points (all P<0.001). Short-term prognostic outcomes were significantly better in 654-1+blood purification group, including shorter duration of vasoactive drug use (Z=2.456, P=0.014), shorter duration of blood purification therapy (Z=3.131, P=0.002), shorter ICU length of stay (Z=2.540, P=0.011) and shorter total hospital duration (Z=3.482, P<0.001).

The addition of 654-1 to blood purification therapy is associated with improved short-term clinical outcomes in patients with septic shock. During blood purification therapy for patients with septic shock, the combined use of 654-1 can improve short-term clinical prognosis.